Electronic application to improve management of infections in low-income neonatal units: pilot implementation of the NeoTree beta app in a public sector hospital in Zimbabwe

BMJ Open Quality

article

Hannah Gannon¹  Simbarashe Chimhuya²  Gwendoline Chimhini²  Samuel R Neal¹  Liam P Shaw³  Caroline Crehan¹  Tim Hull-Bailey¹  Rashida A Ferrand⁴  Nigel Klein⁶  Michael Sharland⁷  Mario Cortina Borja¹  Valerie Robertson⁸  Michelle Heys¹  Felicity C Fitzgerald⁵ 

[1] Department of Population, Policy & Practice , University College London Great Ormond Street Institute of Child Health;Department of Paediatrics and Child Health , University of Zimbabwe;Nuffield Department of Medicine , University of Oxford;London School of Hygiene & Tropical Medicine;Biomedical Research and Training Institute;Infection, Immunity & Inflammation Dept , University College London Great Ormond Street Institute of Child Health;St George's University of London;Department of Medical Microbiology , University of Zimbabwe;Specialist Children’s and Young People’s Services , East London NHS Foundation Trust

关键词: paediatrics;    electronic health records;    global health;    healthcare quality improvement;   

DOI  :  10.1136/bmjoq-2020-001043

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

There are 2. 4 million annual neonatal deaths worldwide. Simple, evidence-based interventions such as temperature control could prevent approximately two-thirds of these deaths. However, key problems in implementing these interventions are a lack of newborn-trained healthcare workers and a lack of data collection systems. NeoTree is a digital platform aiming to improve newborn care in low-resource settings through real-time data capture and feedback alongside education and data linkage. This project demonstrates proof of concept of the NeoTree as a real-time data capture tool replacing handwritten clinical paper notes over a 9-month period in a tertiary neonatal unit at Harare Central Hospital, Zimbabwe. We aimed to deliver robust data for monthly mortality and morbidity meetings and to improve turnaround time for blood culture results among other quality improvement indicators. There were 3222 admissions and discharges entered using the NeoTree software with 41 junior doctors and 9 laboratory staff trained over the 9-month period. The NeoTree app was fully integrated into the department for all admission and discharge documentation and the monthly presentations became routine, informing local practice. An essential factor for this success was local buy-in and ownership at each stage of the project development, as was monthly data analysis and presentations allowing us to rapidly troubleshoot emerging issues. However, the laboratory arm of the project was negatively affected by nationwide economic upheaval. Our successes and challenges piloting this digital tool have provided key insights for effective future roll-out in Zimbabwe and other low-income healthcare settings.paediatricselectronic health recordsglobal healthhealthcare quality improvementhttp://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND